title: HEp-2 cell-adherent Escherichia coli and intestinal secretory immune response to human immunodeficiency virus (HIV) in outpatients with HIV-associated diarrhea.
abstract: HEp-2 cell-adherent Escherichia coli and the human immunodeficiency virus (HIV) itself have recently been incriminated as causes of chronic HIV-associated diarrhea. This study sought to determine the prevalence of these two agents among HIV-infected patients with diarrhea in an outpatient setting in the United States and to compare their prevalence to that of other commonly recognized enteropathogens known to be present in this population. HEp-2 cell-adherent E. coli was found in 20 of 83 (24.1%) patients with diarrhea. A diffuse pattern of adherence was the most common, found in 14 of 20 (70%) patients, followed by a localized adherence pattern (6 of 20; 30%). An intestinal secretory immune response against the p24 antigen of HIV was found in 9 of 34 (27.5%) patients with HIV-associated diarrhea. The following pathogens or products were also detected in lower frequencies: Cryptosporidium spp. (10.8%), Clostridium difficile toxin (8.8%), microsporidia (6%), Isospora belli (3.6%), Blastocystis hominis (2.4%), Giardia spp. (1.2%), Salmonella spp. (1.2%), and Mycobacterium spp. (1.2%). The role of HEp-2 cell-adherent E. coli and HIV enteric infections in patients with HIV-associated diarrhea deserves further study.
authors.affiliation: Center for Infectious Diseases, The University of Texas School of Public Health and Medical School, Houston 77030, USA. JMATHEWSON@UTSPH.SPH.UTH.TMC.EDU
authors.forename: J J
authors.initials: JJ
authors.lastname: Mathewson
authors.forename: B M
authors.initials: BM
authors.lastname: Salameh
authors.forename: H L
authors.initials: HL
authors.lastname: DuPont
authors.forename: Z D
authors.initials: ZD
authors.lastname: Jiang
authors.forename: A C
authors.initials: AC
authors.lastname: Nelson
authors.forename: R
authors.initials: R
authors.lastname: Arduino
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
authors.forename: N
authors.initials: N
authors.lastname: Masozera
mesh_terms: D001422:Bacterial Adhesion / Q000502:physiology; D018791:CD4 Lymphocyte Count; D004926:Escherichia coli / Q000302:isolation & purification*; D006678:HIV / Q000276:immunology*; D016655:HIV Core Protein p24 / Q000276:immunology; D019053:HIV Enteropathy / Q000276:immunology* / Q000382:microbiology*; D006801:Humans; D018928:Immunity, Mucosal / Q000276:immunology; D007071:Immunoglobulin A, Secretory / Q000032:analysis; D007410:Intestinal Diseases / Q000276:immunology / Q000382:microbiology; D007411:Intestinal Diseases, Parasitic / Q000276:immunology; D007413:Intestinal Mucosa / Q000276:immunology*; D010045:Outpatients; D014407:Tumor Cells, Cultured / Q000382:microbiology*
chemical_list: D016655:HIV Core Protein p24; D007071:Immunoglobulin A, Secretory